Hunter Stuart A, Lawrie Stephen M
Division of Psychiatry, Royal Edinburgh Hospital, University of Edinburgh, Edinburgh, UK.
Curr Top Behav Neurosci. 2018;40:353-388. doi: 10.1007/7854_2018_46.
The search for diagnostic and prognostic biomarkers in schizophrenia care and treatment is the focus of many within the research community. Longitudinal cohorts of patients presenting at elevated genetic and clinical risk have provided a wealth of data that has informed our understanding of the development of schizophrenia and related psychotic disorders.Imaging follow-up of high-risk cohorts has demonstrated changes in cerebral grey matter of those that eventually transition to schizophrenia that predate the onset of symptoms and evolve over the course of illness. Longitudinal follow-up studies demonstrate that observed grey matter changes can be employed to differentiate those who will transition to schizophrenia from those who will not prior to the onset of the disorder.In recent years our understanding of the genetic makeup of schizophrenia has advanced significantly. The development of modern analysis techniques offers researchers the ability to objectively quantify genetic risk; these have been successfully applied within a high-risk paradigm to assist in differentiating between high-risk individuals who will subsequently become unwell and those who will not.This chapter will discuss the application of imaging and genetic biomarkers within high-risk groups to predict future transition to schizophrenia and related psychotic disorders. We aim to provide an overview of current approaches focussing on grey matter changes that are predictive of future transition to illness, the developing field of genetic risk scores and other methods being developed to aid clinicians in diagnosis and prognosis.
在精神分裂症护理和治疗中寻找诊断和预后生物标志物是研究界许多人的关注焦点。具有高遗传和临床风险的患者纵向队列提供了丰富的数据，有助于我们理解精神分裂症及相关精神障碍的发展。对高危队列的影像学随访表明，最终发展为精神分裂症的患者在症状出现之前大脑灰质就发生了变化，且在病程中不断演变。纵向随访研究表明，观察到的灰质变化可用于在疾病发作前区分哪些人会发展为精神分裂症，哪些人不会。近年来，我们对精神分裂症基因组成的理解有了显著进展。现代分析技术的发展使研究人员能够客观地量化遗传风险；这些技术已成功应用于高危范式，以帮助区分哪些高危个体随后会发病，哪些不会。本章将讨论高危人群中影像学和基因生物标志物在预测未来发展为精神分裂症及相关精神障碍方面的应用。我们旨在概述当前的方法，重点关注可预测未来发病的灰质变化、遗传风险评分的发展领域以及正在开发的其他辅助临床医生进行诊断和预后判断的方法。
